Menorrhagia, which requires a hysterectomy, is
rarely a condition where the periods are merely heavy. They are
often irregular, painful, associated with PMS, menstrual headaches,
anaemia, exhaustion and depression. Every prospective study, there
are now 13, looking at the effects of hysterectomy on depression
in these sort of patients shows that this is usually helped by hysterectomy
and efficient HRT (Fig 5). In spite of this, crusading journalist
often write that hysterectomy causes depression, loss of sexuality,
with great harm to the general health and marital relationship.
Nothing could be further from the truth but it is essential to give
hormones which adequately replace the missing ovarian hormones if
oophorectomy has been performed which will usually be oestradiol
and testosterone inserted as pellets into the wound at the time
of closure.